基于循证药学评价关节周围注射布比卡因脂质体对全膝关节置换术后疼痛和膝关节功能恢复的效果  

Evaluation on the effect of liposomal bupivacaine using periarticular injection on pain and knee functional recovery in total knee arthroplasty based on evidence-based pharmacy

作　　者：刘岳峰 胡建华 刘红辉 廖国平 孙德贵 LIU Yuefeng;HU Jianhua;LIU Honghui;LIAO Guoping;SUN Degui(Changning Hospital of Traditional Chinese Medicine,Changning 421500,China)

机构地区：[1]常宁市中医医院,湖南常宁421500

出　　处：《临床医药实践》2021年第4期252-258,共7页Proceeding of Clinical Medicine

摘　　要：目的:基于循证药学手段,评价关节周围注射布比卡因脂质体对全膝关节置换术(TKA)后疼痛和膝关节功能恢复的效果。方法:计算机检索PubMed,EMBASE,The Cochrane Library和中国知网,收集关节周围注射布比卡因脂质体对TKA术后疼痛和膝关节功能恢复效果的临床研究。从纳入的研究中提取资料并对其进行质量评价,再用RevMan 5.3软件进行Meta分析。结果:最终纳入4项随机对照临床试验和7项对照临床试验,共96532例患者。Meta分析结果显示:关节周围注射布比卡因脂质体组患者在疼痛模拟评分(VAS)、阿片类药物总消耗量、关节活动度、行走距离、住院时间和术后恶心发生率等方面与对照组比较,差异均无统计学意义(P>0.05)。结论:与关节周围注射常规镇痛药物比较,布比卡因脂质体对TKA术后具有相似的镇痛和膝关节功能恢复效果。Objective:To evaluate the effect of liposomal bupivacaine using periarticular injection on pain and knee functional recovery in total knee arthroplasty(TKA)based on evidence-based pharmacy.Methods:Clinical trials regarding the effect of liposomal bupivacaine by periarticular injection on pain and knee functional recovery in TKA were searched in the databases PubMed,EMBASE,The Cochrane Library and CNKI.We extracted data and assessed the quality of the literature and adopted RevMan 5.3 to conduct meta-analysis on each effective index.Results:A total of 96532 patients from 4 RCTs and 7 CCTs were included in this meta-analysis.Our pooled data analysis demonstrated that liposomal bupivacaine was as effective as the control group in terms of visual analog scale score at 24 hours,72 hours,total amount of opioid consumption,range of motion,ambulation distance,length of hospital stay and postoperative nausea.Conclusion:Compared with the conventional periarticular injection method,liposomal bupivacaine shows similar pain control and knee functional recovery after TKA.

关 键 词：布比卡因 关节周围注射 疼痛 膝关节功能恢复 全膝关节置换术 循证药学 

分 类 号：R687.4[医药卫生—骨科学]